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1528840584
CAMILLIA CLARK
IDAHO FALLS, ID
NPI
1528840584
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID COUI-9541)
Enumeration Date
2023-10-16
Last Update Date
2023-10-16
Business Address
CAMILLIA CLARK COUI-9541
452 D ST
IDAHO FALLS, ID 83402-3531
Phone number: 208-552-0355
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Mailing Address
CAMILLIA CLARK COUI-9541
452 D ST
IDAHO FALLS, ID 83402-3531
Phone number: 208-552-0355
Copy
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